Uterine Tube Encircling Small Bowel Causing Mechanical Obstruction, Case Report and Literature Review

Introduction: Intestinal obstruction is one of the common presentations of patients with acute abdomen to the Surgical Emergency Department, and it is associated with significant morbidity and mortality. The most common causes of acute small bowel obstruction are adhesions and an obstructed hernia. One of the rare causes of acute small bowel obstruction is constriction of bowel wall by fallopian tubes, and it usually occurs secondary to adhesions of previous obstetric and gynecological surgeries. Other gynecological causes include endometriosis and Pelvic inflammatory diseases. Case Presentation: We are presenting a 56-year-old married female, who is presented with features of acute mechanical intestinal obstruction for duration of two days. She had a history of Caesarian Section, however, no other significant history. CT scan abdomen confirmed the clinical finding and showed closed loop small bowel obstruction with radiological signs of mesenteric ischemia. Diagnostic laparoscopy was done, and the intraoperative finding was constriction band formed by left tube causing obstruction of ileal loop segment and intestinal obstruction. Discussion: One of the rare causes of mechanical small bowel obstruction is gynecological causes like endometriosis, internal hernia or like in our case fallopian tube adhesions causing a constriction band. The intraoperative decision is challenging and often required skillful laparoscopic surgeon in order to minimize morbidity and preserve the functioning tube.